How useful is the center for epidemiologic studies depression scale in screening for depression in adults? An updated systematic review and meta-analysis✰

Gender, age, and longitudinal measurement invariance of child and adolescent depression scales: A systematic review

Understanding developmental trajectories and gender differences in depressive symptoms is clinically relevant. Discerning true differences across gender, age groups, and time is based on the often-neglected premise of measurement invariance (MI) of child and adolescent depression scales. In this systematic review, we assessed available evidence for MI across gender, age groups, and time for depression scales validated in children and adolescents, in studies with at least one assessment under age 18. A literature search using Medline, PsychInfo, Scopus, Web of Science, and Google Scholar databases identified 42 studies that examined MI. MI of eleven scales was tested in 1-9 studies per scale. Conclusions are hampered by different factor solutions tested within some scales. All included questionnaires showed preliminary evidence for MI across gender. Across some studies, crying had higher factor loadings in females compared to males, indicating that crying may be differently related to depression across gender. MI evidence was preliminary in just four scales across time, mostly confined to ages 13-17. One study showed developmental conclusions differed when non-invariance is not accounted for in observed scores. Overall, evidence for MI in child and adolescent depression scales is currently limited.

The long-term consequences of school suspension and expulsion on depressive symptoms

Exposure to exclusionary discipline has been tied to several deleterious outcomes in adulthood, including contact with the criminal legal system. While this work provides interesting insight into the long-term consequences tied to this form of school punishment, few have attempted to consider whether and how, exclusionary discipline practices, in particular, school suspension and expulsion shape mental health patterning over the life course. Using panel data from the National Longitudinal Study of Adolescent to Adult Health, we contribute to this body of literature by examining whether exposure to school suspension or expulsion shapes depressive symptom trajectories from adolescence to adulthood. Results from our mixed-effects linear growth curve models demonstrate both forms of exclusionary discipline play a significant role in depressive symptom trajectories. We find suspended and expelled youth exhibit significantly higher depressive symptoms in adolescence when compared to their counterparts with no history of suspension or expulsion. Results also show age variation in depressive symptom trajectories by history of exposure to exclusionary discipline. Specifically, results show the depressive symptoms gap between disciplined and non-disciplined youth slightly dissipates as youth age into early adulthood, but as individuals begin to transition out of this stage of the life course, the gap in depressive symptoms widens substantially. Results carry implications for how punitive disciplinary practices in schools shape mental health from adolescence to adulthood.

Urea Level and Depression in Patients with Chronic Kidney Disease

Depression is common in patients with chronic kidney disease (CKD). Experimental studies suggest the role of urea toxicity in depression. We assessed both the incidence of antidepressant prescriptions and depressive symptoms (measured by CESD (Center for Epidemiologic Depression) scale) in 2505 patients with CKD (Stage 3-4) followed up over 5 years in the Chronic Kidney Disease Renal Epidemiology and Information Network (CKD-REIN) cohort. We used a joint model to assess the association between the serum urea level and incident antidepressant prescriptions, and mixed models for the association between the baseline serum urea level and CESD score over the 5-year follow-up. Among the 2505 patients, 2331 were not taking antidepressants at baseline. Of the latter, 87 started taking one during a median follow-up of 4.6 years. After adjustment for confounding factors, the hazard ratio for incident antidepressant prescription associated with the serum urea level (1.28 [95%CI, 0.94,1.73] per 5 mmol/L increment) was not significant. After adjustment, the serum urea level was associated with the mean change in the CESD score (β = 0.26, [95%CI, 0.11,0.41] per 5 mmol/L increment). Depressive symptoms burden was associated with serum urea level unlike depression events. Further studies are needed to draw firm conclusions and better understand the mechanisms of depression in CKD.

The reliability, validity and clinical utility of the Clinical Outcomes in Routine Evaluation - ten-item version (CORE-10) in post-acute patients with stroke

OBJECTIVE

To explore the validity, reliability, and clinical utility of the Clinical Outcomes in Routine Evaluation - ten-item version (CORE-10: a ten-item questionnaire designed to measure psychological distress) in a stroke inpatient sample and calculate reliable and clinically significant change scores.

SETTING

A post-acute stroke rehabilitation ward in the East of England.

PARTICIPANTS

A total of 53 patients with stroke, capable of completing the CORE-10 as part of their routine clinical assessment. Exclusion criteria included moderate to severe aphasia and/or alexia.

MAIN MEASURES

Alongside the CORE-10, the Patient Health Questionnaire - 9, the Hospital Anxiety and Depression Scale, the Centre for Epidemiological Studies-Depression Scale, and the Beck Depression Inventory Second Edition were used as concurrent measures.

RESULTS

To assess reliability, the internal consistency and test-retest reliability of the CORE-10 were calculated. The average number of days between CORE-10 test-retest administrations was 2.84 (SD = 3.12, Mdn = 1). Concurrent validity was assessed by examining correlations between the CORE-10 and comparable measures, and clinical utility was assessed using the criteria of Burton and Tyson (2015). The internal consistency (Cronbach's alpha) for the CORE-10 was .80, and test-retest reliability interclass correlation coefficient was .81. Total score correlations between the CORE-10 and concurrent measures ranged from r = .49 to r = .89. The CORE-10 achieved the maximum score (i.e. 6/6) on criteria for clinical utility. Calculations demonstrated a reliable change index of nine points and a clinically significant change cut point of 12 on the CORE-10. Percentiles for CORE-10 total scores are reported.

CONCLUSIONS

This study provides preliminary support for the CORE-10 as a valid and reliable measure that has clinical utility for screening distress in inpatients with stroke.

Effects of short- and long-term exposures to multiple air pollutants on depression among the labor force: A nationwide longitudinal study in China

BACKGROUND

Depression prevalence has surged within the labor force population in recent years. While links between air pollutants and depression were explored, there was a notable scarcity of research focusing on the workforce.

METHODS

This nationwide longitudinal study analyzed 27,457 workers aged 15-64. We estimated monthly mean concentrations of fine particulate matter (PM2.5), its primary components, and Ozone (O3) at participants' residences using spatiotemporal models. To assess the relationship between short- (1 to 3 months) and long-term (1 to 2 years) exposure to various air pollutants and depressive levels and occurrences, we employed linear mixed-effects models and mixed-effects logistic regression. We considered potential occupational moderators, such as labor contracts, overtime compensation, and total annual income.

RESULTS

We found significant increases in depression risks within the workforce linked to both short- and long-term air pollution exposure. A 10 μg/m3 rise in 2-year average PM2.5, black carbon (BC), and O3 concentrations correlated with increments in depressive scores of 0.009, 0.173, and 0.010, and a higher likelihood of depression prevalence by 0.5 %, 12.6 %, and 0.7 %. The impacts of air pollutants and depression were more prominent in people without labor contracts, overtime compensation, and lower total incomes.

CONCLUSION

Exposures to air pollutants could increase the risk of depression in the labor force population. The mitigating effects of higher income, benefits, and job security against depression underscore the need for focused mental health interventions.

The role of depression between sleep disorders and frailty among elderly patients with chronic kidney disease (CKD) in China: a cross-sectional study

OBJECTIVE

To investigate the correlation among sleep disorders, physical frailty, and depression in elderly patients with chronic kidney disease (CKD), and to explore the mediating role of depression.

METHODS

This was a cross-sectional study, simple sampling was used to investigate the elderly CKD patients from one tertiary hospital in Shanghai. Those CKD patients who were diagnosed as CKD1-5 phase and were admitted to the Renal Medicine Ward from January to June 2022 and provided formal consent were considered for inclusion in our study. They were investigated with frailty phenotype (FP), Pittsburgh sleep quality index (PSQI), Center for Epidemiological Studies Depression Scale (CES-D), and self-made general information questionnaire. Linear regression was used to assess the associations between the variables, before this, PROCESS v4.1 was used to transform PSQI, CES-D and FP score to improve its normality, and conduct intermediary analysis. A difference of p < 0.05 was statistically significant.

RESULTS

A total of 504 elderly patients with CKD completed the questionnaire survey, aged 60-91. The incidence of sleep disorders among elderly patients with CKD was 60%, and the incidence of physical frailty was 18%. The depression was positively correlated with physical frailty (r = 0.418, p < 0.01) and sleep disorders (r = 0.541, p < 0.01). Physical frailty was positively correlated with sleep disorders (r = 0.320, p < 0.01). The depression plays a significant mediating role in the model, and the effect ratio of depression is 52%.

CONCLUSION

Depression is a mediating variable between sleep disorders and frailty. Improving depression in elderly patients with CKD accompanied by sleep disorders can help delay the occurrence of frailty.

Sense of Freedom in the Golden Years: Disentangling the Complex Ties Between Community Safety Concerns and Depressive Symptoms in Later Life

This study investigates the "Negative Spillover Effect"-a conceptual framework that highlights the correlation between older adults' community safety concerns and depressive symptoms. It explores the moderating influence of the sense of freedom in this relationship. Through the analysis of data from 3408 participants in the China Labor-force Dynamics Survey, employing a two-stage least squares regression approach, the study uncovers the intricate role of the sense of freedom in influencing the depressive symptoms of older adults based on their community safety concerns. The sense of freedom serves as a protective factor against the adverse psychological effects of community safety concerns when they are strong. However, this protective role diminishes when coupled with a low perception of the fair match between labor input and living condition rewards. The study underscores the importance of addressing and mitigating the negative spillover effect to foster sustainable and equitable community development. Reducing these adverse effects is essential for enhancing the mental health and well-being of the older demographic.

Strength training has antidepressant effects in people with depression or depressive symptoms but no other severe diseases: A systematic review with meta-analysis

Depression and subthreshold depressive symptoms reduce quality of life and function and treatment does not work effectively in one-third of patients. Exercise can reduce depressive symptoms, but more information is required regarding strength training (ST). The objective of the present meta-analysis was to summarize and estimate the efficacy of ST in people with a diagnosis of depression or subthreshold depressive symptoms and no other severe disease. We also aimed to explore the variables that could influence the antidepressant effects. PubMed, Embase, Web of Science, PsyINFO, CINAHL, and SPORTDiscus were searched from inception to August 2022. The overall effect antidepressant of training was moderate (SMD = -0.51, 95 % CI -0.72 to -0.30, p < 0.001). The meta-regression demonstrated preliminary evidence that the variables: duration of the intervention in weeks, weekly frequency of the intervention, number of sets, and number of repetitions can influence the antidepressant effects. However, these variables had a small role in the variation of the effect.

Outdoor light at night and depressive symptoms in male veterans: a multicenter cross-sectional study in China

Previous studies have indicated depression was associated with environmental exposures, but evidence is limited for the association between outdoor light at night (LAN) and depression. This study aims to examine the association between long-term outdoor LAN exposure and depressive symptoms using data from the Chinese Veteran Clinical Research platform. A total of 6445 male veterans were selected from 277 veteran communities in 18 cities of China during 2009‒2011. Depressive symptoms were evaluated using the Chinese version of the Center for Epidemiological Studies Depression scale. Outdoor LAN was estimated using the Global Radiance Calibrated Nighttime Lights data. The odds ratio and 95% confidence intervals of depressive symptoms at the high level of outdoor LAN exposure against the low level during the 1 years before the investigation was 1.49 (1.15, 1.92) with p-value for trend < 0.01, and those associated with per interquartile range increase in LAN exposure was 1.22 (1.06, 1.40).

Optimal cut-offs of depression screening tools during the COVID-19 pandemic: a systematic review

BACKGROUND

Studies have reported an increase in the prevalence of depression during the COVID-19 pandemic. The accuracy of screening tools may change with the prevalence and distribution of a disease in a population or sample: the "Spectrum Effect".

METHODS

First, we selected commonly used screening tools and developed search strategies for the inclusion of original studies during the pandemic. Second, we searched PsycINFO, EMBASE, and MEDLINE from March 2020 to September 2022 to obtain original studies that investigated the accuracy of depression screening tools during the pandemic. We then searched these databases to identify meta-analyses summarizing the accuracy of these tools conducted before the pandemic and compared the optimal cut-offs for depression screening tools during the pandemic with those before.

RESULT

Four original studies evaluating the optimal cut-offs for four screening tools (Beck Depression Inventory [BDI-II], Hospital Anxiety and Depression Scale-Depression [HADS-D], Patient Health Questionnaire-9 [PHQ-9], and Geriatric Depression Scale-4 [GDS-4]) were published during the pandemic. Four meta-analyses summarizing these tools before the pandemic. We found that the optimal cut-off of BDI-II was 14 during the pandemic (23.8% depression prevalence, screening patients with Type 2 diabetes) and 14.5 before the pandemic (17.6% depression prevalence, screening psychiatric, primary care, and healthy populations); HADS-D was 10 during the pandemic (23.8% depression prevalence, screening patients with type 2 diabetes) and 7 before the pandemic (15.0% depression prevalence, screening medically ill patients); PHQ-9 was 11 during the pandemic (14.5% depression prevalence, screening university students) and 8 before the pandemic (10.9% depression prevalence, screening the unrestricted population), and GDS-4 was 1.8 during the pandemic (29.0% depression prevalence, screening adults seen in a memory clinic setting) and 3 before the pandemic (18.5% depression prevalence, screening older adults).

CONCLUSION

The optimal cut-off for different screening tools may be sensitive to changes in study populations and reference standards. And potential spectrum effects that should be considered in post-COVID time which aiming to improve diagnostic accuracy.

Effects of co-sleeping with a shift worker on sleep, mood and cognition

Objective

Although the negative effects of shift work on workers' sleep and mood are well-known, the effects of shift work on their sleep partners' sleep and mood have rarely been investigated. The current study explored the effects of co-sleeping with a shift worker (SW) on the partner's subjective sleep quality, daytime sleepiness, depressive symptoms, and cognitive disturbances.

Methods

Online sleep and work-environment self-report questionnaires (e.g., including the presence of co-sleepers, work schedules of the co-sleepers, and their work schedules) were administered. The questionnaires also included the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Cognitive Failures Questionnaire (CFQ), and the short-term Center for Epidemiologic Studies-Depression scale (CES-D). Participants consisted of co-sleepers of SWs (n = 657), co-sleepers of non-SWs (n = 2186), and solo sleepers (n = 2432).

Results

Significant between-group differences in the PSQI, ESS, CFQ, and CES-D were observed after controlling for age, gender, work shift, and parenting (p < 0.001). Co-sleepers of SWs showed higher PSQI, ESS, CFQ, and CES-D scores than co-sleepers of non-SWs and solo sleepers. Solo sleepers reported significantly higher PSQI and CES-D scores than co-sleepers of non-SWs. The PSQI, ESS, CFQ, and CES-D scores were significantly correlated in all groups. The association between the ESS and PSQI was stronger in co-sleepers of SWs than in solo sleepers. The association between the ESS and CES-D was stronger in co-sleepers of SWs than in solo sleepers.

Conclusions

Co-sleeping with SWs is associated with poor sleep quality, daytime sleepiness, depressive symptoms, and cognitive disturbances in the partner.

Lower HbA1C of glycemic control is associated with higher risk of depressive symptoms in elderly with type 2 diabetes mellitus-A Nationwide Community-based study

OBJECTIVE

We investigated the correlation between glycemic control status and depressive symptoms in type 2 diabetes elderly.

METHODS

A total of 1527 participants with type 2 diabetes aged 55 years and older from the Healthy Aging Longitudinal Study in Taiwan study were included in this cross-sectional study. The Center for Epidemiologic Studies Depression Scale (CESD) (20 items) score of ≥16 was indicative of depressive symptoms. The participants were divided into HbA1c ≥ 6.5% and < 6.5% representing the glycemic control. Multiple logistic regression (MLR) and Generalized linear model (GLM) were used.

RESULTS

The MLR analysis showed that the low HbA1c group had significant two-fold increased odds of depressive symptoms compared to the high HbA1c group (OR 1.89, 95% CI 1.17-3.05). The risk of depressive symptoms was lower among males (OR 0.49, 95% CI 0.30-0.80) and those with higher BMI (OR 0.93, 95% CI 0.86-1.00); whereas the risk was higher among those who lived alone (OR 2.37, 95% CI 1.31-4.27) and with ADL disability (OR 3.01, 95% CI 1.85-4.89). The GLM showed that the dimension of depressive affect reached statistical significance with lower HbA1c.

CONCLUSION

This nationwide community-based study shows that depressive symptoms are associated with lower HbA1C, reminding us that more attention should be paid to the presence of depressive symptoms in those with lower HbA1C. Further research is needed to clarify the causal relationship.

Cognitive inflexibility is linked to abnormal frontoparietal-related activation and connectivity in obsessive-compulsive disorder

Although it was acknowledged that patients with obsessive-compulsive disorder (OCD) would exhibit cognitive inflexibility, the underlying neural mechanism has not been fully clarified. Therefore, this study aimed to investigate the neural substrates involved in cognitive inflexibility among individuals with OCD. A total of 42 patients with OCD and 48 healthy controls (HCs) completed clinical assessment and functional magnetic resonance imaging (fMRI) data collection during cued task switching. Behavioral performances and fMRI activation were compared between the OCD group and the HC group. Psychophysiological interactions (PPIs) analyses were applied to explore functional connectivity related to task switching. Pearson correlation was used to investigate the relationships among behavioral performance, fMRI activity, and obsessive-compulsive symptoms in OCD. The OCD group had a greater switch cost than HCs (χ2  = 5.89, p < .05). A significant difference in reaction time was found during switch (χ2  = 17.72, p < .001) and repeat (χ2  = 16.60, p = .018) between the two groups, while there was no significant difference in group accuracy. Comparison of group differences showed that the OCD group had increased activation in the right superior parietal cortex (rSPL) during task switching, and exhibited increased connectivity of frontoparietal network/default mode network (FPN-DMN; i.e., middle frontal gyrus [MFG]/inferior parietal cortex-precuneus, MFG-middle/posterior cingulate gyrus) and within the FPN (inferior parietal cortex-postcentral gyrus). In the OCD group, the compulsion score was positively correlated with accuracy during switch (r = .405, p = .008, FDRq <.05), and negatively correlated with activation of rSPL (r = -.328, p = .034, FDRq >.05). Patients with OCD had impaired cognitive flexibility and cautious response strategy. The neural mechanism of cognitive inflexibility in OCD may involve increased activation in the rSPL, as well as hyperconnectivity within the FPN and between the FPN and DMN.

Examining the links between burnout and suicidal ideation in diverse occupations

Introduction

It is uncertain whether burnout is associated with suicidal ideation among workers not in health care services. The aim of this study was to identify how burnout and suicidal ideation are linked among employees in various occupations and whether depression affects this link.

Methods

This cross-sectional study collected data from 12,083 participants aged 19-65 years from 25 companies and public institutions who underwent workplace mental health screening. Burnout and depression were assessed using both the Oldenburg Burnout Inventory and the Center for Epidemiologic Studies Depression Scale. Suicidal ideation was assessed by a self-rated questionnaire from the Korea National Health and Nutrition Examination Survey.

Results

Exhaustion but not the cynicism dimension of burnout was associated with increased odds of suicidal ideation after adjustment for depression and other covariates (odds ratio [OR] = 1.47, 95% CI = 1.26-1.72). The association of exhaustion with suicidal ideation was significant in both depressed (OR = 1.36, 95% CI = 1.14-1.61) and not depressed (OR = 1.77, 95% CI = 1.13-2.76) participants. In exhausted participants, insufficient job control, an unfavorable occupational climate, low educational level, and depression were associated with increased odds of suicidal ideation.

Conclusion

Exhaustion is linked with risk of suicidal ideation in employees not in health care service, regardless of depression status. Exhausted employees, particularly those having poor job resources, should be recognized as an at-risk group.

Differences in Center for Epidemiologic Studies Depression Scale, Generalized Anxiety Disorder-7 and Kessler Screening Scale for Psychological Distress Scores between Smartphone Version versus Paper Version Administration: Evidence of Equivalence

The use of electronic patient-reported outcomes has increased recently, and smartphones offer distinct advantages over other devices. However, previous systematic reviews have not investigated the reliability of the Center for Epidemiologic Studies Depression Scale (CES-D), Generalized Anxiety Disorder-7 (GAD-7), and Kessler Screening Scale for Psychological Distress (K6) when used with smartphones, and this has not been fully explored. This study aimed to evaluate the equivalence of the paper and smartphone versions of the CES-D, GAD-7, and K6, which were compared following a randomized crossover design method in 100 adults in Gunma, Japan. Participants responded to the paper and smartphone versions at 1-week intervals. The equivalence of paper and smartphone versions was evaluated using the intraclass correlation coefficient (ICC_agreement). The mean participant age was 19.86 years (SD = 1.08, 23% male). The ICC_agreements for the paper and smartphone versions of the CES-D, GAD-7, and K6 were 0.76 (95% confidence interval [CI] 0.66-0.83), 0.68 (95% CI 0.59-0.77), and 0.83 (95% CI 0.75-0.88), respectively. Thus, the CES-D and K6 scales are appropriate for use in a smartphone version, which could be applied to clinical and research settings in which the paper or smartphone versions could be used as needed.

Cognitive performance is associated with glomerular filtration rate in patients with chronic kidney disease: results from the CKD-REIN cohort

BACKGROUND

Chronic kidney disease (CKD) is associated with cognitive impairment in general population. We assessed the association between kidney and cognitive functions in patients with CKD and the influence of cardiovascular (CV) risk factors, and depression on this association.

METHODS

The CKD-Renal Epidemiology and Information Network cohort included 3033 patients with CKD stages 3-4, followed for 5 years. Cognitive function was assessed with the Mini-Mental State Examination (MMSE) and estimated glomerular filtration rate (eGFR) with the CKD-Epidemiology Collaboration equation-creatinin formula. Evolution of the MMSE score over time and its association with baseline eGFR were investigated with linear mixed models. We assessed the risk of incident cognitive outcome (hospitalisation or death with relevant International Classification of Disease-10 codes), with a Cox proportional hazard model.

RESULTS

The mean age was 66.8, the mean eGFR was 33 mL/min/1.73 m² and 387 patients (13.0%) had an MMSE score below 24 at baseline. A 10 mL/min/1.73 m² decrement of baseline eGFR was associated with a mean MMSE decrease of 0.12 (95% CI 0.04 to 0.19) after adjustment for demographic characteristics, depression, CV risk factors and disease; but baseline eGFR was not associated with MMSE temporal evolution. HR for cognitive outcome during follow-up (median 2.01 years) associated with a 10 mL/min/1.73 m² decrement of baseline eGFR was 1.35 (1.07, 1.70) (p=0.01) after adjustment.

CONCLUSIONS

In patients with CKD, lower eGFR was associated with worse cognitive performance and incident cognitive events, independently of demographics, CV risk factors and depression.

TRIAL REGISTRATION NUMBER

NCT03381950.

Study on anxiety and depression of men who have sex with men: An application of group-based trajectory model

The prevalence of anxiety and depression is high among men who have sex with men (MSM), but limited studies focus on their development trends. This study examined the prevalence and influencing factors of anxiety and depression in HIV-negative MSM. In this study, 711 subjects were followed up every 24 weeks for 96 weeks. A group-based trajectory model was used to identify different development trends and a logistic regression model was used to explore the influencing factors of different trajectories. Low, moderate, and high anxiety groups accounted for 32.56, 56.12, and 11.32%; and low and high depression groups accounted for 73.90 and 26.10%. High anxiety was associated with a lower education degree, little HIV-related knowledge, and other characteristics (more agreed that "HIV is a threat to me/my family," had high frequency of seeking sexual partners via the Internet, had a history of sexually transmitted disease (STD), and a sense of discrimination by doctors). High depression was associated with a lower education degree, little HIV-related knowledge, being bisexual and the following characteristics: they felt that HIV infection rate of MSM around them was high, and more agreed that "HIV is a threat to me/my family," had a high frequency of seeking sexual partners through the Internet and alcohol drinking, had a history of STD, and felt being discriminated against by doctors and others. There is heterogeneity in the development trends of anxiety and depression. We need to improve intervention in the mental health of MSM, especially those with high anxiety and depression development trends.

Clinical Trial Registration

[http://www.chictr.org.cn/showproj.aspx?proj=5716], identifier [ChiCTR-TRC-13003849].

Changes in life satisfaction, depression, general health and sleep quality of Spanish older women during COVID-19 lockdown and their relationship with lifestyle: an observational follow-up study

OBJETIVES

To analyse the effects of COVID-19 lockdown on mental well-being variables of older women, and to determine the influence of lifestyle and age on such effects. The hypothesis of the study was that all parameters related to mental well-being would worsen in older women during the COVID-19 lockdown.

DESIGN

Observational follow-up study. Pre lockdown measurements were taken before the lockdown. Post lockdown measurements were taken as soon as began the de-escalation.

SETTING

Senior centres in the Region of Murcia (Spain).

PARTICIPANTS

The sample was composed of 40 older women volunteers, over 54 years of age (mean age=62.35±8.15 years).

PRIMARY AND SECONDARY OUTCOME MEASURES

Pre lockdown and post lockdown evaluations were carried out face to face. The following questionnaires were completed: Satisfaction with Life Scale, The Center for Epidemiologic Studies Depression Scale, The Short Form 36 Health Survey, The Pittsburgh Sleep Quality Index, the Global Physical Activity Questionnaire and Prevention with Mediterranean Diet.

RESULTS

Post lockdown, a worsening was found in the variables of life satisfaction (p=0.001); depression (p<0.001), quality of life in physical role (p=0.006), pain (p=0.004), emotional role (p<0.001) and mental health (p<0.001); and sleep quality (p=0.018), sleep latency (p=0.004), sleep disturbances (p=0.002) and global sleep quality score (p=0.002). It was found how age influenced the variables of pain (p=0.003) and social role (p=0.047), as well as the influence of a healthy lifestyle on the variables analysed (F=6.214; p=0.017). Adherence to the Mediterranean diet was shown to be a protective factor against increased depression (p=0.03). Spending time sitting was shown to be a risk factor for physical role health (p=0.002), as was advanced age on health due to worsening pain (p=0.005), or an unhealthy lifestyle on increased consumption of sleeping aids (p=0.017).

CONCLUSION

The lockdown had a great negative impact on Spanish older women on mental well-being variables.

TRIAL REGISTRATION NUMBER

NCT04958499.

Gratitude Can Help Women At-Risk for Depression Accept Their Depressive Symptoms, Which Leads to Improved Mental Health

Introduction

Gratitude is commonly known as a positive emotion, but it can also be understood as a disposition-one's inherent quality that includes being grateful for the positive aspects of one's life and appreciating altruistic gifts. A growing body of research suggests that having a disposition of gratitude is positively related to wellbeing and psychological adjustment. The present study examined the extent to which acceptance of illness-a measure of adjustment to a distressing condition-mediated relationships between dispositional gratitude and wellbeing among women who had elevated levels of depressive symptoms.

Methods

Participants were 131 women who, based on scores on the Center for Epidemiological Studies Depression scale, were at-risk for experiencing clinical depression. Thirty-five of these participants had been diagnosed as depressed at some point in their lives and 96 had not. Participants completed measures of dispositional gratitude, wellbeing, anxiety, and acceptance of illness.

Results

Dispositional gratitude was positively correlated with wellbeing and was negatively correlated with depression and anxiety. Dispositional gratitude was also positively correlated with acceptance of illness. Mediational analyses found that acceptance of illness mediated relationships between dispositional gratitude and wellbeing, between dispositional gratitude and anxiety, and between dispositional gratitude and depression. Moreover, such mediation varied as a function of whether women had ever been diagnosed as depressed. Acceptance of illness was related more strongly to wellbeing for women who had been diagnosed as depressed at some time in their lives than it was for women who had never been diagnosed as depressed.

Conclusion

Women with elevated depressive symptoms who were more grateful (compared to those who were less grateful) were more accepting of their condition, which was related to increased wellbeing and decreased feelings of depression and anxiety.

The effects of rational emotive behavior therapy for depressive symptoms in adults with congenital heart disease

BACKGROUND

Over 30% of adults with congenital heart disease (CHD) experience depression.

OBJECTIVES

To evaluate the effectiveness of Rational Emotive Behavior Therapy (REBT) in reducing depressive symptoms in adults with CHD.

METHODS

Forty-two adults with CHD were recruited from an outpatient clinic and randomized to a study group (n = 21), which comprised 8-weekly group-based counseling sessions, or a control group (n = 21), which received usual care. REBT effectiveness was examined using the Hamilton Depression Rating Scale, Beck Depression Inventory, Shorten General Attitude and Belief Scale, and salivary cortisol levels before therapy, after the last session, and at follow-up 4 weeks later.

RESULTS

Average participant ages were 30.1 ± 7.58 and 33.3 ± 7.1 years in study and control groups, respectively; 52.4% of participants in each group were female. After REBT, depression (p < 0.001), irrational beliefs (p < 0.001), and salivary cortisol levels (p = 0.006) were significantly lower in the study group than in the control group. Effects of REBT in the study group remained consistent at the 4-week follow-up.

CONCLUSION

REBT may be effective in reducing depression in adults with CHD.